Stroke patients with impairment of executive functioning could benefit from antidepressants
Antidepressants can improve long-term so-called “executive” functioning in stroke patients, a new study indicates.
The study investigators explain that impairment of such functions, which
allow individuals to respond appropriately to unfamiliar and complex
situations, occurs in most stroke patients. They predicted that antidepressant
treatment would improve executive dysfunction, independent of depression.
In a double-blind trial, 47 patients who had had a stroke during the
previous six months received 12 weeks of antidepressant treatment (nortriptyline
or fluoxetine) or placebo.
There was no significant difference in executive function between the
two groups at the end of the treatment phase but, after 21 months, the
placebo group showed deterioration in executive function, whereas the
active treatment group showed improvement, irrespective of depressive
symptoms.
The researchers suggest possible mechanisms to explain the findings,
pointing out that antidepressants enhance the development of immature
neurons in the brain, which may promote reorganisation of limbic and
frontal brain structures.
The study is published in The British Journal of Psychiatry (2007;190:260).
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